Joe is a 68 year old patient that presented with chest pain and shortness of breath that began while carrying
pipes on a construction site. Patient feels like he is suffocating and describes chest pain as a dull pressure that has never been experienced before. Patient reports that many years ago, a primary care physician said he may need some "work" on his heart but patient "doesn't know what that means." Patient no longer sees the doctor. The patient has a history of hypertension, rheumatic fever as a child, and while in the Navy was exposed to asbestos in the shipyard. He is married with two children and currently works as a plumber. He denies tobacco and illicit drug use and states he only drinks beer occasionally. The only medications the patient takes is atenolol and aspirin.